Arizona Form 333 - Credit For Employing National Guard Members - 2015 Page 3
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3Your Name (as shown on Form 333, page 1)
Your Social Security or Employer Identification Number
Page
of
Form 333-1
Qualifying Employees
2015
(a)
(b)
(c)
(d)
(e)
(f)
Did this employee serve on active duty
Was this employee in
during the taxable year for training that
a full-time employment
exceeds the required annual training
Social Security
Date placed
position when placed
period, including any activation for federal
Employee Name
Date of Hire
Number
on Active Duty
on active duty?
or state contingencies or emergencies?
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If you have more than 16 qualifying employees, complete additional schedules and include with the form.
ADOR 10714 (15)
Print 333-1
Clear 333-1
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